Bleeding into the skin

Alternative names:

bruising; ecchymoses; hematomas; petechiae; pinpoint red spots on the skin; skin spots - red

Definition:

Bleeding into the skin, subcutaneous tissues, or mucous membranes. Purpura are flat areas where blood has collected under the tissue; a hematoma is a larger collection that forms a lump.

Considerations:

Aside from the common bruise, bleeding into the skin or mucus membranes is a very significant sign and should always be evaluated. Bleeding that consists of pinpoint dots of blood is called petechiae. Larger areas of bleeding up to approximately a centimeter in diameter are called purpura, while a very large area is called an ecchymosis.

Redness of the skin (erythema) should not be mistaken for bleeding. Petechiae, purpura, and ecchymosis do not blanch (become pale) with pressure, while the redness of erythema decreases and then returns when pressure is applied and released.

Common causes:

• local injury or trauma
• allergic reaction
• autoimmune disorders
• viral infection or illness affecting blood coagulation
• thrombocythemia
• medical treatment, including radiation and chemotherapy
• bruise (ecchymosis)
• birth (petechiae in the newborn)
• aging skin (ecchymosis)
• idiopathic thrombocytopenic purpura (petechiae and purpura)
• Henoch-Schonlein purpura (purpura)
• leukemia (purpura and ecchymosis)
• drugs
  • anticoagulants such as warfarin or heparin (ecchymosis)
  • aspirin (ecchymosis)
  • cortisone (ecchymosis)

• septicemia (petechiae, purpura, ecchymosis)
• violent vomiting or coughing (petechiae)

Note: There may be other causes of bleeding into the skin. This list is not all inclusive, and the causes are not presented in order of likelihood. The causes of this symptom can include unlikely diseases and medications. Furthermore, the causes may vary based on age and gender of the affected person, as well as on the specific characteristics of the symptom such as location, quality, time course, aggravating factors, relieving factors, and associated complaints. Use the Symptom Analysis option to explore the possible explanations for bleeding into the skin, occurring alone or in combination with other problems.